Phone: (816) 908-9651
Email: chase.miller@adjuvantpt.com
For all prospective clients, please download and fill out the below form prior to your first appointment to the best of your ability. These same documents will be made available through the patient portal for ease in the future. If you have questions, please contact (816) 908-9651 so we can assist.
Click below to download our Welcome Letter. This letter provides an overview of what you can expect during your first visit and outlines our commitment to your care. Please read this letter prior to your appointment.
Please click below to download our General Intake Form. This form helps us understand your medical history and current health condition. Kindly fill it out accurately and bring it with you for your initial appointment.
To ensure we can provide the best possible care, we require your consent to release medical information. Please click below to download, complete, and bring this Consent/Release of Information form to your first visit.
Our Financial Agreement form outlines our payment policies. Please click below to download, review, sign, and bring this form to your appointment. This will help streamline the financial aspects of your care.
Understanding your current medications is crucial for your treatment plan. Please click below to download our Medication List form. Fill it out with all the medications you're currently taking and bring it with you to your first appointment.